Car travel time and accessibility by bus to general practitioner services: a study using patient registers and GIS

• Published in: Social science & medicine (1982) Vol. 55; no. 1; pp. 97 - 111
• Main Authors: Lovett, Andrew, Haynes, Robin, Sünnenberg, Gisela, Gale, Susan
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford Elsevier Ltd 01.07.2002; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Access; Accessibility; Accessibility Bus services GIS GP services Patient registers Rural deprivation UK; Analysis. Health state; Automobiles; Biological and medical sciences; Bus services; Buses; Catchment Area (Health); East Anglia; England; Epidemiology; Family Practice; General aspects; General practice; Geographic information systems; Geography; GIS; GP services; Health care access; Health Services Accessibility - classification; Health Services Accessibility - statistics & numerical data; Humans; Information Systems; Location; Medical sciences; Motor cars; Needs Assessment; Patient registers; Patients; Primary Health Care; Public health. Hygiene; Public health. Hygiene-occupational medicine; Public Transportation; Registries; Rural deprivation; Rural health care; Rural Population; Small-Area Analysis; Socioeconomic Factors; Spatial Analysis; Surgery; Time; Transport; Transportation; United Kingdom; Europe; England; United Kingdom > UK; GIS; Accessibility; Rural deprivation; GP services; UK; Patient registers; Bus services; Human; Rural environment; Geographic distribution; Register; Health; Primary health care; Transport; Epidemiology; Public health; Inequality
• DOI: 10.1016/S0277-9536(01)00212-X
• ISSN: 0277-9536

Accessibility to general practitioner (GP) surgeries was investigated in a population study of East Anglia (Cambridgeshire, Norfolk and Suffolk) in the United Kingdom. Information from patient registers was combined with details of general practitioner surgery locations, road network characteristics, bus routes and community transport services, and a geographical information system (GIS) was used to calculate measures of accessibility to surgeries by public and private transport. Outcome measures included car travel times and indicators of the extent to which bus services could be used to visit GP surgeries. These variables were aggregated for wards or parishes and then compared with socio-economic characteristics of the populations living in those areas. The results indicated that only 10% of residents faced a car journey of more than 10 min to a GP. Some 13% of the population could not reach general medical services by daily bus. For 5% of the population, the car journey to the nearest surgery was longer than 10 min and there was no suitable bus service each weekday. In the remoter rural parishes, the lowest levels of personal mobility and the highest health needs indicators were found in the places with no daytime bus service each weekday and no community transport. The overall extent of accessibility problems and the existence of inverse care law effects in some rural localities have implications for the NHS, which aims to provide an equitable service to people wherever they live. The research also demonstrates the potential of patient registers and GIS as research and planning tools, though the practical difficulties of using these data sources and techniques should not be underestimated.